Hemodynamic aspects of reduced platelet adhesion on bioinspired microstructured surfaces.

Occlusion by thrombosis due to the absence of the endothelial cell layer is one of the most frequent causes of failure of artificial vascular grafts. Bioinspired surface structures may have a potential to reduce the adhesion of platelets contributing to hemostasis. The aim of this study was to investigate the hemodynamic aspects of platelet adhesion, the main cause of thrombosis, on bioinspired microstructured surfaces mimicking the endothelial cell morphology. We tested the hypothesis that platelet adhesion is statistically significantly reduced on bioinspired microstructured surfaces compared to unstructured surfaces. Platelet adhesion as a function of the microstructure dimensions was investigated under flow conditions on polydimethylsiloxane (PDMS) surfaces by a combined experimental and theoretical approach. Platelet adhesion was statistically significantly reduced (by up to 78%; p≤0.05) on the microstructured PDMS surfaces compared to that on the unstructured control surface. Finite element method (FEM) simulations of blood flow dynamic revealed a micro shear gradient on the microstructure surfaces which plays a pivotal role in reducing platelet adhesion. On the surfaces with the highest differences of the shear stress between the top of the microstructures and the ground areas, platelet adhesion was reduced most. In addition, the microstructures help to reduce the interaction strength between fluid and surfaces, resulting in a larger water contact angle but no higher resistance to flow compared to the unstructured surface. These findings provide new insight into the fundamental mechanisms of reducing platelet adhesion on microstructured bioinspired surfaces and may lay the basis for the development of innovative next generation artificial vascular grafts with reduced risk of thrombosis.

Quantitative characterization of endothelial cell morphologies depending on shear stress in different blood vessels of domestic pigs using a focused ion beam and high resolution scanning electron microscopy (FIB-SEM).

Microstructured surfaces mimicking the endothelial cell (EC) morphology is a new approach to improve the blood compatibility of synthetic vascular grafts. The ECs are capable of changing their shapes depending on different shear conditions. However, the quantitative correlation between EC morphology and shear stress has not yet been investigated statistically. The aim of this study was to quantitatively investigate the morphology of ECs in dependence on the shear stress. Blood flow rates in different types of natural blood vessels (carotid, renal, hepatic and iliac arteries) originated from domestic pigs were first measured in vivo to calculate the shear stresses. The EC morphologies were quantitatively characterized ex vivo by imaging with high resolution scanning electron microscopy (SEM) and cross-sectioning of the cells using a state-of-the-art focused ion beam (FIB). The relationships between EC geometrical parameters and shear stress were statistically analyzed and found to be exponential. ECs under high shear stress conditions had a longer length and narrower width, i.e. a higher aspect ratio, while the cell height was smaller compared to low shear conditions. Based on these results, suitable and valid geometrical parameters of microstructures mimicking EC can be derived for various shear conditions in synthetic vascular grafts to optimize blood compatibility.

[Another genetic cause of sudden cardiac death]. / Endnu en genetisk årsag til pludselig uventet hjertedød.

Mutations in the Lamin A/C gene (LMNA) are a new part of the spectrum of genes responsible for sudden cardiac death (SCD). Relatives of SCD-cases should receive counselling, clinical assessment and perhaps molecular screening. The consequence of being an LMNA mutation carrier is discussed with regard to counselling and prophylactic measures. Device therapy may be relevant in LMNA-mutation carriers, although the proper time for implantation is uncertain. However, we recommend LMNA genetic screening in SCD cases with dilated cardiomyopathy as well as cases with unexplained SCD.